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Reproductive Health

What is Annovera? Meet the new Vaginal Contraceptive Ring

by MICHELLE KONSTANTINOVSKY

From patches and pills to condoms and injections, you’ve got a lot to consider when it comes to birth control. And while the vaginal ring isn’t exactly a new form of contraception, there’s a new type of ring that could be a gamechanger for some women. Meet Annovera.  

“Annovera is a newly approved, super exciting vaginal ring for contraception that’s effective for a full year,” says New York-based OB/GYN, Alyssa Dweck, MS, MD, FACOG. “It’s an estrogen/progestin combination ring that’s used for 21 days per month and removed for seven days per month.”

How the Vaginal Ring Works

If you’ve never used or considered using NuvaRing, you might have some questions about this whole vaginal ring concept. Let’s back up. When it originally came on the market in 2001, NuvaRing was advertised as “the world’s first monthly vaginal ring for birth control.” Unlike birth control pills which are taken orally, the NuvaRing is a small (about two inches), flexible, plastic device that women can insert directly into their vaginas to prevent pregnancy. By continuously releasing synthetic estrogen and progestin that’s absorbed into the bloodstream which prevents ovulation and thickens the cervical mucus to help keep sperm out. 

While the delivery method of hormones is certainly different from oral contraceptives, NuvaRing shares something in common with many types of birth control pills: it’s used for three consecutive weeks at a time and then discarded and replaced after a one-week break. This reprieve from the hormones is what triggers a withdrawal bleed, which mimics the regular menstrual period women who don’t use birth control get once per cycle. While that system makes sense for many women, others find it difficult or impossible to regularly refill prescriptions at the pharmacy or visit the doctor’s office for prescription renewals. That’s where Annovera comes in. 

A bit about me before we get started. I’m a work-from-home content manager for an online fitness education company with a flexible, yet demanding schedule. Working in the health/fitness space, I definitely have nutrition on the brain much of the time (plus, I love to eat!). I’m also a martial artist, and I do about 4-6 hours of intense, high impact training most weeks. 

Meet Annovera

Last August, the global nonprofit research organization, The Population Council, announced it had received U.S. Food and Drug Administration (FDA) approval for “the first and only contraceptive that provides an entire year of protection against unintended pregnancy while fully under a woman’s control.” Unlike NuvaRing, this similarly shaped and sized Annovera can be inserted and removed each cycle by the user for a full year. 

When it comes to efficacy and safety, Annovera is considered a strong contender, alongside other more old-school methods of birth control. According to the results of three clinical trials with healthy women ranging from 18 to 40 years of age, about two to four women out of 100 may get pregnant during the first year they use Annovera. By comparison, NuvaRing is about 98% effective — just like birth control pills.  

“Annovera is the second birth control ring to come to market,” says Kate White, MD MPH, director of the Family Planning Fellowship and associate professor of OB/GYN at Boston University. “What makes this different than NuvaRing is that a single Annovera ring lasts for an entire year. You use it much like the other ring — in your body for three weeks, out for one week — but can then put it back in for your next cycle. So no more running to the pharmacy for monthly refills! The ring can be washed and stored in a case (not in your fridge) when it’s not in use.”

The Risks and Realities of Annovera

Like any medication, Annovera does have some risks. “It has the same general precautions as the combination pill, including for smokers over 35 years old,” Dweck says. “The most common side effect is headache, and it hasn’t been studied in women with a body mass index (BMI) greater than 29.”

The FDA also cautions that Annovera shouldn’t be used by women with certain medical conditions like current or history of breast cancer, undiagnosed abnormal uterine bleeding, liver tumors, and more. Aside from headaches, women who use Annovera may experience side effects like nausea and vomiting, yeast infections, abdominal pain, dysmenorrhea (painful periods), breast tenderness, irregular bleeding, diarrhea, and/or genital itching.

If it sounds like Annovera might be the right birth control option for you, then it might be time to talk to your doctor. But be prepared to wait a little while longer before you can actually test drive the product yourself: Annovera isn’t set to hit the U.S. market until the end of this year or early next year.